Moving Forward on Health Care

With the exception of what we’re hearing from a few people like Jonathan Cohn, the rapidly congealing conventional wisdom of the Washington pundit class is that health care reform is a non-starter next year. The assumption taking hold is that Barack Obama simply can’t afford to tackle it; he can’t afford the money, and he can’t afford the political capital. The way things generally work in Washington, the longer that idea stays out there, the more likely it is to become a reality.

That would be unfortunate, if recent history is any guide. In 1993, Bill Clinton decided to put off health care reform until his second year, focusing instead on putting some points on the board with his deficit-reduction plan and NAFTA. The hope was that these victories would add momentum that would aid the health care effort. The reality turned out to be the opposite: By the time Clinton finally got around to health care in 1994, his political capital had been drained and spent. Will Obama make the same calculation? As Hillary Clinton told me in an interview shortly before Election Day this year: “It’s important to move simultaneously on several fronts, and I know how difficult that is. But a new president has a honeymoon period. … I hope that we’re going to really make progress on health care, right off the bat, with a new Congress. … I think the bottom line is that Americans are voting for change, and by that they mean they want to see a better life for themselves and their families and their country—and we’re going to have to produce that.”

That’s why the 87-page health care white paper that Senate Finance Committee Chairman Max Baucus released today–to much acclaim by unions and other groups interested in health care reform–could be so important. The policy details are not all that significant; the only real difference from Barack Obama’s plan is that Baucus would put in a so-called “individual mandate,” which is a requirement that individuals who do not get coverage from their employers buy it on the open market. Obama would make that decision voluntary, though his plan, like Baucus’s, would strive to make it easier for people to afford it. The key thing is that this is a signal from the chairman of the Finance Committee–one of the biggest hurdles for any effort–that he is intent on moving forward. What remains to be seen is whether Congress and the new administration see health care reform as a priority that is secondary to an economic recovery, or one that is crucial making that recovery happen.